| NPI | 1306135785 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 108670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.124229) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2022-10-05 |