| NPI | 1790342996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4351044920) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5315206972) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2020-04-04 |