| NPI | 1548589245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101018645) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2014002142) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2022-12-01 |