| NPI | 1770010712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 72753) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 66849) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-10-31 |