| NPI | 1932297934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.090863) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 029917) |
| 207P00000X Emergency Medicine (Licence: WV 23000) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-02-06 |