| NPI | 1982869657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 53834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 21199) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2022-02-04 |