| NPI | 1568789519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-35655) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2012009734) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2023-12-11 |