| NPI | 1629430681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35137458) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.027648) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-06-23 |