| NPI | 1912946138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 41358) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 62662) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-03-09 |