| NPI | 1962441741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 64975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD428814) |
| 207P00000X Emergency Medicine (Licence: WI 72262) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2024-02-07 |