| NPI | 1699405381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-51179) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 9355) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2025-07-01 |