| NPI | 1053670281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 19367) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.012074) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2019-01-17 |