| NPI | 1952340689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 40085) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66215-20) |
| 207P00000X Emergency Medicine (Licence: CO DR 0052329) | |
| 207P00000X Emergency Medicine (Licence: OR MD22459) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2024-06-14 |