| NPI | 1902464704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 18154) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351044698) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2022-06-22 |