| NPI | 1306080312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13212201-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34-010116) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2023-05-19 |