| NPI | 1801475447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 83274-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351047937) |
| 207P00000X Emergency Medicine (Licence: MN 78053) | |
| 207P00000X Emergency Medicine (Licence: IA MD-53766) | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2024-10-07 |