| NPI | 1134743677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.147812) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL84256) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2024-04-03 |