| NPI | 1699137216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 65495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 87173-20) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2026-06-02 |