NPI | 1659630309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 59331) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 64089-20) |
Enumeration Date | 2012-05-15 |
Last Update Date | 2022-05-09 |