| NPI | 1669403762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: ND 4565) |
| Additional Taxonomies | 207PT0002X Emergency Medicine Medical Toxicology (Licence: MN 29890) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MN 29890) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-11-25 |