| NPI | 1114453248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.016399) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: IA R-11751) |
| 207P00000X Emergency Medicine (Licence: PA OT017913) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2023-05-04 |