| NPI | 1306893631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 39966) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35076970S) |
| 207P00000X Emergency Medicine (Licence: TN 34619) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2007-11-19 |