| NPI | 1154664936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME140809) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35131846) |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2023-10-26 |