| NPI | 1174386841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 50.009387RX) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MS PA00778) |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2025-04-16 |