NPI | 1003499070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 76792) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 97402) |
Enumeration Date | 2021-04-28 |
Last Update Date | 2025-09-18 |