| NPI | 1861791196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-49307) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 055348) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2024-06-07 |