| NPI | 1770947194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101025492) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101025492) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2020-11-03 |