| NPI | 1245441559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 82067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57012072) |
| 207P00000X Emergency Medicine (Licence: RI MD13199) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2019-07-15 |