| NPI | 1336589365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301102999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301102999) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2019-08-21 |