| NPI | 1215314083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 60943620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.148821) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2024-08-08 |