| NPI | 1407885031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.081429) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101237433) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2021-07-07 |