| NPI | 1841243292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102202993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN DO1771) |
| 207P00000X Emergency Medicine (Licence: OH 34008110) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-01-28 |