| NPI | 1417513250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-46347) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 94-09804) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2022-08-16 |