| NPI | 1194173872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 69919) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 65544) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-03-29 |