| NPI | 1275506735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-25126) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: KS 04-25126) |
| 207P00000X Emergency Medicine (Licence: KS 04-25126) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2018-06-20 |