| NPI | 1144528589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 44888) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R2104) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2012-04-17 |