| NPI | 1538573613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 62377) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105695) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2018-03-17 |