| NPI | 1770146326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 05561) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 05561) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2024-05-13 |