| NPI | 1417167982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-33268) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-33258) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-03-17 |