| NPI | 1043862782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 67758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 30043) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2023-11-15 |