| NPI | 1386267649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0547589) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL83165) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2025-04-22 |