| NPI | 1487145025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2022017307) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101025843) |
| 207P00000X Emergency Medicine (Licence: KS 05-46168) | |
| 207P00000X Emergency Medicine (Licence: MI 5101023948) | |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2024-10-11 |