| NPI | 1407238363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT208368) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.149531) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2024-05-07 |