| NPI | 1821385436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.122960) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R72784) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2014-08-04 |