| NPI | 1851731533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 38172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301102625) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2024-02-01 |