| NPI | 1609941251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2017039490) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 82260) |
| 207P00000X Emergency Medicine (Licence: MI 4301508615) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2024-04-11 |