| NPI | 1851604383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 60337) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301096539) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2024-09-17 |