| NPI | 1346405271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 29631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.014521) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-04-27 |