| NPI | 1285020032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60827347) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.130863) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-07-09 |