| NPI | 1750327342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 23498) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101222977) |
| 207P00000X Emergency Medicine (Licence: TN 32100) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2017-04-18 |