| NPI | 1295198679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2023-01848) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-40667) |
| 207P00000X Emergency Medicine (Licence: AL MD.37879) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AL MD.37879) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-06-05 |