| NPI | 1679787071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.130511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101243473) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-05-16 |