| NPI | 1437149937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 45772) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 45680) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-10-08 |