| NPI | 1518193788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 56310-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301094414) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2018-03-17 |