| NPI | 1770102758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023008417) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351046726) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2023-08-03 |