| NPI | 1487755088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0432725) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 9369) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2018-03-17 |