| NPI | 1508284308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D83165) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.129813) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2023-01-30 |