| NPI | 1942876032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023008611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 95-00025) |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2024-07-17 |