| NPI | 1083660922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY C0174) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 14398) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-08-17 |