| NPI | 1558489476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD-14417) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57008964) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2021-06-02 |