| NPI | 1972163723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 71270) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 8521) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2023-03-28 |