| NPI | 1548674179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 67108-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105535) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-12-31 |