| NPI | 1891322327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-50838) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0069537) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-07-29 |