| NPI | 1043475999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 57.014589) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 246384) |
| 207P00000X Emergency Medicine (Licence: WA MD60341462) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2014-03-13 |