| NPI | 1972588663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2020025229) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-36278) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2024-07-18 |