| NPI | 1477073336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 79747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6879) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2025-10-30 |