| NPI | 1629284559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 83298) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.001926) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-01-27 |