| NPI | 1518224047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 59010) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 63983-20) |
| Enumeration Date | 2012-04-22 |
| Last Update Date | 2022-07-09 |