| NPI | 1417395567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 85492) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 49284) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2022-08-09 |