| NPI | 1083639454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 41275) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101236393) |
| 207P00000X Emergency Medicine (Licence: AR E-3369) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-02-17 |