| NPI | 1689203150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.150005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD480581) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-07-16 |