| NPI | 1629497730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS14573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.012240) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2024-03-31 |