| NPI | 1255358891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 45459) |
| 207P00000X Emergency Medicine (Licence: IN 02002087A) | |
| 207P00000X Emergency Medicine (Licence: IL 036-102964) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-03-18 |