| NPI | 1306956016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-01599) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: KY 36862) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-03-19 |