| NPI | 1033859228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 96377) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.152631) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2026-07-22 |