| NPI | 1689622508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35051536H) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 22016) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-07-21 |