| NPI | 1033301304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2236) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 23617) |
| 207P00000X Emergency Medicine (Licence: OH 34.008958) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2023-12-26 |