| NPI | 1164639597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 1438) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34009109) |
| 207P00000X Emergency Medicine (Licence: MD H67390) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2021-02-23 |