| NPI | 1154860237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C2-0024675) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H0102940) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD H0102940) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA OS026130) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: DE C2-0024675) | |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2026-07-30 |