| NPI | 1487098463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.127580) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME137738) |
| 207P00000X Emergency Medicine (Licence: IN 01082645A) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2024-04-15 |