| NPI | 1942568233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 68659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 131344) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2024-02-02 |