| NPI | 1972543064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 46833) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 38748) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-01-18 |