| NPI | 1548213390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 42966) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 59544) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2023-07-27 |