| NPI | 1164629135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0433538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-33538) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2024-04-08 |