| NPI | 1013949478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 35747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 430024) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-01-11 |