| NPI | 1093207060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 4505) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.015477) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-03-18 |