| NPI | 1073732384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 86966) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.089748) |
| 207P00000X Emergency Medicine (Licence: OH 57009269) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-02-18 |