| NPI | 1467899500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.129636) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 055087) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-07-21 |