| NPI | 1831540947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 292601) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301110796) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2024-07-09 |