| NPI | 1013982669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 37067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 31834) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2015-03-18 |