| NPI | 1013476365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 91814) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.143968) |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2024-07-16 |