| NPI | 1598380123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81238) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014514) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2023-07-17 |