| NPI | 1245491588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 59288) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME 2189) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-10-09 |