| NPI | 1376998336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.134202) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01081619A) |
| 207P00000X Emergency Medicine (Licence: MO 2019020166) | |
| 207P00000X Emergency Medicine (Licence: IL 036148281) | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2020-01-16 |