| NPI | 1316292527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 15167) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101150) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-05-13 |