| NPI | 1225327620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 60993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66319-20) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2017-02-17 |