| NPI | 1538789466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.147554) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.43642) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2023-06-15 |