| NPI | 1336257013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36458) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-079138) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-04-18 |