| NPI | 1578850889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101258448) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI L2048164) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2024-07-26 |