| NPI | 1497067490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 069682) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL32667) |
| 207P00000X Emergency Medicine (Licence: KY 47065) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2016-08-22 |