| NPI | 1225076458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.076915) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 21326) |
| 207P00000X Emergency Medicine (Licence: OH H09359) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-02-26 |