| NPI | 1285155283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2021-00694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101023505) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-10-27 |