| NPI | 1598956708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 59810) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 37193) |
| 207P00000X Emergency Medicine (Licence: WI 64458-20) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2022-07-05 |