| NPI | 1346263365 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.128103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.128103) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-05-04 |