| NPI | 1316102270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 13988) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092753) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-10-29 |