| NPI | 1740509777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 56195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 60502-20) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2024-07-31 |