| NPI | 1205330479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.146743) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2021-00382) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-04-08 |