| NPI | 1649205493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 44305) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301082237) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-04-21 |