| NPI | 1407198518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 22135) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.126893) |
| 207P00000X Emergency Medicine (Licence: WA MD60714498) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2022-04-11 |