| NPI | 1669600433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA DO.000333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101018321) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2020-04-06 |