| NPI | 1023437837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 274295) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 274295) |
| 207P00000X Emergency Medicine (Licence: OH 35.129598) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2020-06-25 |