| NPI | 1336102847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-07-4098) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 15858C) |
| 207P00000X Emergency Medicine (Licence: ME MD17582) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2024-03-11 |