| NPI | 1508245143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 15087) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND PT15087) |
| 207P00000X Emergency Medicine (Licence: MI 5101021797) | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2023-12-27 |