| NPI | 1497987226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 52959) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 72497) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2020-10-07 |