| NPI | 1598010316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 13833) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101325) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2024-05-09 |