| NPI | 1184044281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.141558) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101260013) |
| 207P00000X Emergency Medicine (Licence: MS 25394) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2021-05-05 |