| NPI | 1205830759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35081559) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01075910A) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2024-08-01 |