| NPI | 1477131340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 77185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351047860) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-06-09 |