| NPI | 1770781635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101017125) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS9579) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2026-05-20 |