| NPI | 1154327229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 20277) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.139018) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2026-01-22 |