| NPI | 1568570133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: KS 04-21743) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-21743) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2015-08-18 |