| NPI | 1912344045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C1-0023930) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD22703) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-09-21 |