| NPI | 1588121677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 87591) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.014929) |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2023-06-02 |