| NPI | 1710965207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 71663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101013225) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2024-06-11 |