| NPI | 1831324649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 49887) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.016060) |
| 207P00000X Emergency Medicine (Licence: OH 35.098385) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2023-08-02 |