| NPI | 1255918389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: KS 9411681) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 9411681) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2024032603) | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-05-11 |