| NPI | 1336127109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0530787) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2004007009) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2022-05-20 |