| NPI | 1639465669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101019144) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2023024808) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-08-01 |