| NPI | 1073552394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 58-001352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO212820) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-12-20 |