| NPI | 1639346653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ND 11473) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 20449) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2022-03-25 |