| NPI | 1740442995 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 53290) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 53290) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2016-09-06 |