| NPI | 1528124054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME0039141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.047773) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2024-03-26 |