| NPI | 1235660028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 20022-00760) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.135587) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2022-06-10 |