| NPI | 1093782161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 42477) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 43319) |
| 207P00000X Emergency Medicine (Licence: MA 286019) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2021-06-29 |