| NPI | 1326279118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 65717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301095141) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2022-06-01 |