| NPI | 1104454024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.015668) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AK 219658) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-03-27 |