| NPI | 1932369709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 25959) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD444076) |
| 207P00000X Emergency Medicine (Licence: MI 4301093067) | |
| 207P00000X Emergency Medicine (Licence: OH 35.123474) | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2024-04-26 |