| NPI | 1700203957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-39907) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017005190) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2025-08-18 |