| NPI | 1851321848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 63574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 33142) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2019-02-14 |