| NPI | 1417937491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 45679) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MN 45679) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-03-04 |