| NPI | 1396991923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 57-013166) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 258316) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2025-01-14 |