| NPI | 1558308429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 44488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 21856-020) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-07-08 |