| NPI | 1164535332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 19636) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 038050) |
| 207P00000X Emergency Medicine (Licence: OH 35083684) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2017-02-02 |