| NPI | 1699206094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301506524) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 64638) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-09-05 |