| NPI | 1427008119 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35041542E) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35041542) | 
| Enumeration Date | 2006-05-11 | 
| Last Update Date | 2024-05-21 |