| NPI | 1013476837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.144124) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301511226) |
| 207P00000X Emergency Medicine (Licence: NY 314539) | |
| 207P00000X Emergency Medicine (Licence: IN 01088955A) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-08-20 |