| NPI | 1558883124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H0096516) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151013959) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2023-06-09 |