| NPI | 1417244732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX 46076) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 12860I) |
| 207P00000X Emergency Medicine (Licence: OH 35.126557) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2018-03-17 |