| NPI | 1518587377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5151014484) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101026452) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2023-07-03 |