| NPI | 1437180338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME94320) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2007016523) |
| 207P00000X Emergency Medicine (Licence: KS 04-32631) | |
| 207P00000X Emergency Medicine (Licence: KY 61022) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-09-15 |