| NPI | 1568806842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2016011923) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-38864) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2021-06-29 |