| NPI | 1740293380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 48956) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 233926) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-10-08 |