| NPI | 1811330442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 60419) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66385) |
| Enumeration Date | 2013-04-13 |
| Last Update Date | 2021-05-07 |