| NPI | 1639243488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 093953) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 42891) |
| 207P00000X Emergency Medicine (Licence: OR MD27310) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2010-09-28 |