| NPI | 1447665542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 23431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 65277) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2021-04-07 |