| NPI | 1982620829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY C1946) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301095539) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-04-25 |