| NPI | 1972007227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM DO2022-0025) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 05-44651) |
| 207P00000X Emergency Medicine (Licence: NV sl1370) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2022-08-10 |