| NPI | 1851705800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO2782) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5315064708) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2025-03-06 |