| NPI | 1235399908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 52856) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 60366-20) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-11-30 |