| NPI | 1649361650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 54424) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND 10222) |
| 207P00000X Emergency Medicine (Licence: WI 56309-020) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-08-12 |