| NPI | 1558325860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 31548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31548) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2017-11-14 |