| NPI | 1649832668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3214) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014034) |
| 207P00000X Emergency Medicine (Licence: MI 5101026295) | |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2022-07-14 |