| NPI | 1174598825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 19277) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 36313) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2023-04-28 |