| NPI | 1780706283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-1556) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO28302) |
| 207P00000X Emergency Medicine (Licence: MI 5101016020) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2022-03-25 |