| NPI | 1811481567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101027358) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 51010241678) |
| 207P00000X Emergency Medicine (Licence: NY 311195) | |
| Enumeration Date | 2018-06-17 |
| Last Update Date | 2023-09-07 |