| NPI | 1841872827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 74661) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 85568) |
| 207P00000X Emergency Medicine (Licence: MN 32686) | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2025-07-07 |