| NPI | 1811518632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 84984-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301508644) |
| 207P00000X Emergency Medicine (Licence: MI 4351046123) | |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2025-08-05 |