| NPI | 1427019652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301080308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 36043) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2021-03-26 |