| NPI | 1366783235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO213513) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID O-1261) |
| 207P00000X Emergency Medicine (Licence: OH 34.012005) | |
| Enumeration Date | 2013-03-02 |
| Last Update Date | 2023-04-25 |