| NPI | 1952441842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200500319) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 22253) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2023-08-30 |