| NPI | 1407139777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2704) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.011646) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2021-04-13 |