| NPI | 1992237770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 75565) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 69441) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2021-09-30 |