| NPI | 1225474760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 51644) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R3214) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2023-06-07 |