| NPI | 1174579908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 03649) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN DO1647) |
| 207P00000X Emergency Medicine (Licence: TN BS7463956) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-03-29 |