| NPI | 1285898031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 11993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092924) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2022-04-04 |