| NPI | 1528296258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301094350) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 55042) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-02-07 |