| NPI | 1518250570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 03818) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R2793) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2023-06-07 |