| NPI | 1427630839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 58.032281) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 339403) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2025-09-15 |