| NPI | 1235393877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.120769) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301092989) |
| 207P00000X Emergency Medicine (Licence: IN 01069186) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2020-09-16 |