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) |
207P00000X Emergency Medicine (Licence: WI 85638-20) | |
Enumeration Date | 2022-03-14 |
Last Update Date | 2025-09-11 |