| NPI | 1457470973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301084421) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 37531) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2023-12-12 |