| NPI | 1184372708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 77516) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 33309) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2024-09-04 |