| NPI | 1912959313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 48720-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 47070) |
| 207Q00000X Family Medicine (Licence: WI 48720) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-08-06 |