| NPI | 1932175072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: KY KY37799) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 37799) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2021-11-17 |