| NPI | 1093779738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 21833) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 32247) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-09-23 |