| NPI | 1437413531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0438442) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-38442) |
| 207Q00000X Family Medicine (Licence: NE TEP6804) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2021-03-24 |