| NPI | 1053672113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 199165) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.018238) |
| 207P00000X Emergency Medicine (Licence: KS 05-36750) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2025-12-23 |