| NPI | 1356700090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.014172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2021-09-01 |