| NPI | 1023374691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 52186) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 265986) |
| 207P00000X Emergency Medicine (Licence: OH 57.021317) | |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2018-09-04 |