| NPI | 1386131381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.018167) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H0095171) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-12-23 |