| NPI | 1043291206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01031005A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-043792) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-07-25 |