| NPI | 1972714533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 10115) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-37803) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-11-02 |