| NPI | 1548221674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 16167) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-05-5494) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-12-19 |