| NPI | 1548765126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME163364) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.137322) |
| 207P00000X Emergency Medicine (Licence: KS 04-45848) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-03-11 |