| NPI | 1598713836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-069248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 291957) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-06-28 |