| NPI | 1588603708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34C.000055) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02003088-A) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2026-06-30 |