| NPI | 1073174934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: NC 2024-01963) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.147264) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2024-08-13 |