| NPI | 1598150690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.133007) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66533-20) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2018-05-15 |