| NPI | 1215241377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102203747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.003539) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 51896) | |
| Enumeration Date | 2010-08-01 |
| Last Update Date | 2022-04-11 |