| NPI | 1518328350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 20A9706) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101022284) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2022-09-27 |