| NPI | 1265411045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 30161) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 15070) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2021-08-25 |