| NPI | 1336637388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101025530) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151009338) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2022-06-22 |