| NPI | 1831570662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 73663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301119164) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2025-02-18 |