| NPI | 1689014037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.130631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 872-L) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2025-08-12 |