| NPI | 1578950481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS15888) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34012849) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2019-09-06 |