| NPI | 1245525484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 56712) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 72477) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2020-10-08 |