| NPI | 1720247950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 06277) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS18907) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2026-01-07 |