| NPI | 1144712977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.142537) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-47059) |
| 207P00000X Emergency Medicine (Licence: IA r-11282) | |
| 207P00000X Emergency Medicine (Licence: IA 11282) | |
| 207P00000X Emergency Medicine (Licence: IA 47509) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-02-26 |