| NPI | 1467751032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-37761) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2013037468) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2021-06-29 |