| NPI | 1063614998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-34497) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C7-0003763) |
| 207P00000X Emergency Medicine (Licence: DE C1-0009023) | |
| 207P00000X Emergency Medicine (Licence: SC 40038) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-11-24 |