| NPI | 1528212982 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101020382)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL DO.4309)  | 
| Enumeration Date | 2008-11-12 | 
| Last Update Date | 2025-09-12 |