| NPI | 1407892383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-089671) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2006-00181) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2025-06-09 |