| NPI | 1508156985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD20922) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35 123526) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2017-04-27 |