| NPI | 1760846752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 310320) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.134626) |
| 207P00000X Emergency Medicine (Licence: TN 61634) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2021-06-14 |