| NPI | 1699204834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-45006) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME162015) |
| 207P00000X Emergency Medicine (Licence: MI 4301112078) | |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2026-07-30 |