| NPI | 1306001862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS11088) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN DO0000002171) |
| 207P00000X Emergency Medicine (Licence: OH 34.009490) | |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2012-10-30 |