| NPI | 1417923665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD26597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35086094) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2022-02-01 |