| NPI | 1558987834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-47695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2020015356) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-07-12 |