| NPI | 1023570421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.142012) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OH 35.142012) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.142012) | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2024-05-23 |