| NPI | 1184006090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 51435) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R3728) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2018-06-22 |