| NPI | 1073141396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 69825) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 30801) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-06-14 |