| NPI | 1376930214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 74204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 51274) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2023-10-17 |