| NPI | 1457670358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC DO36611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 94355) |
| 207P00000X Emergency Medicine (Licence: OH 34.010353) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2023-03-31 |