| NPI | 1992244396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 67399) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101022980) |
| 207P00000X Emergency Medicine (Licence: MI 5151010487) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2020-06-19 |