| NPI | 1396235685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME173594) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351038388) |
| 207P00000X Emergency Medicine (Licence: MI 4301504289) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2025-06-17 |