| NPI | 1346680808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 9881209-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.125273) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2016-11-10 |