| NPI | 1548828734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5151013717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H0097067) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2025-10-06 |