| NPI | 1487148722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 20910) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 68596) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2021-07-23 |