| NPI | 1548473374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2616) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34008993) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-04-20 |