| NPI | 1326334210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 47110) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL33828) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2015-05-14 |