| NPI | 1972097848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: KS 04-48472) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-48472) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2024-10-04 |