| NPI | 1568429645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 50927-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 47471) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2023-05-02 |