| NPI | 1922068089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 25051) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI L804289) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2018-08-28 |