| NPI | 1033774013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA DO-06365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA DO-06365) |
| 207P00000X Emergency Medicine (Licence: OH 34.015406) | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2025-07-08 |