| NPI | 1215372248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2017-02256) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.011929) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2024-03-28 |