| NPI | 1508443318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 330067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.016543) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-07-27 |