| NPI | 1528169844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-31969) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2004030785) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2014-06-04 |