| NPI | 1467197525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 06042) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.017336) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2025-07-14 |