| NPI | 1346582954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 305245) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301102674) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2022-07-21 |