| NPI | 1932172525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO R8664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0417932) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2016-08-05 |