| NPI | 1699799965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 19863) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 34960) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-12-04 |