| NPI | 1447824537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4351047597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 77055) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2024-05-19 |