| NPI | 1295939619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 24926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 50881) |
| 207P00000X Emergency Medicine (Licence: IN 01067900A) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-04-08 |