| NPI | 1619395886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.130916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2015-01828) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-07-21 |