| NPI | 1669593091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-123373) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA L-218088) |
| 207P00000X Emergency Medicine (Licence: MI 4301090062) | |
| 207P00000X Emergency Medicine (Licence: DC MD037870) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2014-06-11 |