| NPI | 1376103044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 66772) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351045066) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2022-07-08 |