| NPI | 1447660287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301506633) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293315-1) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2022-11-18 |