| NPI | 1255776076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS14971) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH FB5498539) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2019-01-31 |