| NPI | 1225009079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 60514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 20091) |
| 207P00000X Emergency Medicine (Licence: MN 56004) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2019-05-13 |