| NPI | 1235348194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 55089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 231588) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-05-29 |