| NPI | 1063437440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102203299) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34-008040-S) |
| 207P00000X Emergency Medicine (Licence: DE C2-0007296) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2015-05-15 |