| NPI | 1326272014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0053883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R2231) |
| 207P00000X Emergency Medicine (Licence: MD D0073833) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2019-12-20 |