| NPI | 1831332287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 60340) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65067-20) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2022-06-13 |