| NPI | 1730198896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 37083) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 42290) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2021-04-02 |