| NPI | 1275829228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 57774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66518-20) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2022-08-05 |