| NPI | 1508862749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35082976) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01091676A) |
| 207P00000X Emergency Medicine (Licence: CA C175786) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2023-12-21 |