| NPI | 1336534080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 82139) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.026025) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2019-07-15 |