| NPI | 1083925796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 58342) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101018706) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2021-03-29 |