| NPI | 1649581208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 68156) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301097142) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2025-07-24 |