| NPI | 1669932810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 68325) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 30213) |
| 207P00000X Emergency Medicine (Licence: WI 81374) | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2023-07-07 |