| NPI | 1891430112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 74613) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 32489) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2023-07-11 |