| NPI | 1699160044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.146047) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293325) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-05-15 |