| NPI | 1992753966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 53535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.25556) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-04-07 |