| NPI | 1659492189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 58738) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 56333) |
| 207P00000X Emergency Medicine (Licence: ME DO2414) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2025-06-13 |