| NPI | 1700091592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 51749) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021480) |
| 207P00000X Emergency Medicine (Licence: MN 51749) | |
| 207P00000X Emergency Medicine (Licence: PA OS014414) | |
| 207P00000X Emergency Medicine (Licence: PA OT011680) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-03-11 |