| NPI | 1033498373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 226324) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 48713) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2021-05-26 |