| NPI | 1396277836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 67168) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0076610) |
| 207P00000X Emergency Medicine (Licence: WA MD70053958) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2026-02-27 |