| NPI | 1255838264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.141026) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME146612) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2021-06-03 |