| NPI | 1609822642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101011708) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101011708) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2019-10-10 |