| NPI | 1558595017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.010255) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 269561) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-06-30 |