| NPI | 1548379795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102201730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.007036) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0102201730) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-10-18 |