| NPI | 1881631638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 1525) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301076774) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301076774) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-08-09 |