| NPI | 1407017833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 56033) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 54216) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2014-09-26 |