| NPI | 1558715854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.135034) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME149734) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-02-08 |