| NPI | 1538277611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: KY 34565) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 34565) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2018-01-25 |