| NPI | 1013478437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 71332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 74142) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-04-18 |