| NPI | 1417452509 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.143624)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.143624)  | 
| Enumeration Date | 2018-03-29 | 
| Last Update Date | 2024-07-12 |