| NPI | 1972863900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 03840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 03840) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2024-02-08 |