| NPI | 1487159521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 65876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 29170) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2022-07-20 |