| NPI | 1093026858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 46144) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL32875) |
| Enumeration Date | 2010-06-27 |
| Last Update Date | 2021-03-03 |