| NPI | 1801186127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 66728) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 60617) |
| 207P00000X Emergency Medicine (Licence: IL 036137879) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2018-06-18 |