| NPI | 1518452580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101024144) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101025768) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2025-05-19 |