| NPI | 1760778963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD219022) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301098647) |
| Enumeration Date | 2011-06-26 |
| Last Update Date | 2024-02-21 |