| NPI | 1205835394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.076048) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-076048) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2022-12-07 |