| NPI | 1114983152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35-04-8464-M) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35-04-8464-M) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2022-06-28 |