| NPI | 1548248099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 68765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35053423) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2019-11-27 |