| NPI | 1790224228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO2990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101023021) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2025-01-09 |