| NPI | 1265419600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-25869) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 107228) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2008-07-25 |