| NPI | 1346445699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11547) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017421) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2025-05-09 |