| NPI | 1407416423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301505430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101274875) |
| 207P00000X Emergency Medicine (Licence: TN 65306) | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2022-06-09 |