| NPI | 1699719153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012011806) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 48630) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-09-07 |