| NPI | 1508493511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 7279) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 05-49043) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-08-18 |