| NPI | 1063502326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 74947) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SD 5191) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2024-01-08 |