| NPI | 1649479932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD433950) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.089566) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2021-01-19 |