| NPI | 1831121284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 430057) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-12-17 |