| NPI | 1487735676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301063161) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101058710) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-01-28 |