| NPI | 1285012260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 63900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R10206) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-10-11 |