| NPI | 1043411564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 49858) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35092707) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2022-03-15 |