| NPI | 1811933880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 4162) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34008307) |
| 207P00000X Emergency Medicine (Licence: NE 793) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2013-06-19 |