| NPI | 1457681645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 77047) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01076459A) |
| 207P00000X Emergency Medicine (Licence: OH 35 126059) | |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2024-07-25 |