| NPI | 1962470328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 24793) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 43571) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2015-03-26 |