| NPI | 1154777613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01081130A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.132534) |
| 207P00000X Emergency Medicine (Licence: NY 301189-01) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2022-08-29 |