| NPI | 1700013539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 53514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 53514) |
| 207R00000X Internal Medicine (Licence: MN 53514) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-11-10 |