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 |