| NPI | 1467408245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME115143) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.070831) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-02-10 |