| NPI | 1033590088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 63575) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 7462) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2018-05-30 |