| NPI | 1235116559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35080036) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01081232A) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-03-28 |