| NPI | 1497079966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101018792) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101018792) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2025-02-24 |