| NPI | 1235394180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 12424) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.014549) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2023-11-27 |