| NPI | 1679500409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-22181) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0422181) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2009-07-02 |