| NPI | 1932148665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 42992) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 60188-20) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-05-13 |