| NPI | 1639117146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101016300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 4538) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2025-04-07 |