| NPI | 1700291945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 80126) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021148) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2023-05-24 |