| NPI | 1912402231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 63954) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 29274) |
| 207P00000X Emergency Medicine (Licence: MN 65798) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2023-10-04 |