| NPI | 1679079198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01087223A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.140013) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2022-02-23 |