| NPI | 1689088387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 67094) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 61905) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2021-03-12 |