| NPI | 1871703132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 18077) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301088354) |
| 207P00000X Emergency Medicine (Licence: OH 35.093095) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2016-09-29 |