| NPI | 1134380637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-094666) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: OH 35-094666) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: OH 35.094666) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2022-04-14 |