| NPI | 1073073110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 68256) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 29969) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2023-03-14 |