| NPI | 1396194049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101022249) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101022249) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2023-10-30 |