| NPI | 1568922920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS20188) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014502) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-08-08 |