| NPI | 1902285331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 61008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 72344) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2020-09-29 |