| NPI | 1497780134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 33215-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 78620) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2025-01-10 |