| NPI | 1659833895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021009475) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0446311) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-08-02 |