| NPI | 1235316605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 50457) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 51167) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2019-05-10 |