| NPI | 1093776163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME148011) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 21376) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2024-04-26 |