| NPI | 1629598487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101024580) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101024580) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2020-07-23 |