| NPI | 1629417068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 66409-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105380) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-09-17 |