| NPI | 1518499607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023011931) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 05-44474) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-11-22 |