| NPI | 1477016822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.015675) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.030638) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2023-03-13 |