| NPI | 1063587947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 49580) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME EC-05-141) |
| 207P00000X Emergency Medicine (Licence: WI 87321-20) | |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2026-06-02 |