| NPI | 1396914008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 105591) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 55972-20) |
| 207P00000X Emergency Medicine (Licence: IN 01062465A) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2024-09-26 |