| NPI | 1780909333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME131907) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.120015) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2018-04-17 |