| NPI | 1225616725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 75916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351048014) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2024-07-19 |