| NPI | 1134500093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 33789) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 139063) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-12-06 |