| NPI | 1801863626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35079233) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00042292) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2023-05-16 |