| NPI | 1417092602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS10437) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101015911) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2025-03-13 |