| NPI | 1699084772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35099655) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A127439) |
| 207Q00000X Family Medicine (Licence: IL 125055463) | |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2022-07-21 |