| NPI | 1346879244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2023-00705) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 51511014401) |
| 207P00000X Emergency Medicine (Licence: MA 1019261) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2024-04-24 |