| NPI | 1336521251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 11653) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101022093) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2020-11-13 |