| NPI | 1548216567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-26586) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 38528) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2025-09-08 |