| NPI | 1679749204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 49270) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 51471-020) |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2020-11-04 |