| NPI | 1467035261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 05696) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014756) |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2024-07-02 |