| NPI | 1669739561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.011645) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 265856) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2024-07-16 |