| NPI | 1356760243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-38784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2018004967) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-04-02 |