| NPI | 1417397811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 66522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R73906) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2023-05-16 |