| NPI | 1700535077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-51781) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 0665R) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2025-10-27 |