| NPI | 1093216095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO Dr.0066146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.152800) |
| Enumeration Date | 2018-02-24 |
| Last Update Date | 2025-04-07 |