| NPI | 1275946311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 62018) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-10013) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2022-06-29 |