| NPI | 1417452509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.143624) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MO 2022021493) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-07-03 |