| NPI | 1326068503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 19422) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 34517) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2012-03-27 |