| NPI | 1134351430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 64551-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 54102) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2024-02-21 |