| NPI | 1649684333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 67342-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 7227) |
| 207P00000X Emergency Medicine (Licence: MN 62307) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2018-03-17 |