| NPI | 1922073055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 14857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-23723) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2013-05-02 |