| NPI | 1417310434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301117503) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 86479-20) |
| 207P00000X Emergency Medicine (Licence: FL ME178723) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2026-01-09 |