| NPI | 1629232939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 65823) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092705) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-10-08 |