| NPI | 1861535114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 34148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 42736) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2023-03-07 |