| NPI | 1417080763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.132010) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0427097) |
| 207P00000X Emergency Medicine (Licence: KS 0427097) | |
| 207P00000X Emergency Medicine (Licence: IL 036.150120) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2024-08-25 |