| NPI | 1295027126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY TP715) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 44491) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2022-04-14 |