| NPI | 1639163488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301076150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0089037) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2020-10-20 |