| NPI | 1437374303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 55012) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 31604) |
| 207P00000X Emergency Medicine (Licence: CA A114119) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2013-02-09 |