| NPI | 1174789978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.010056) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 329935) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2024-06-20 |