| NPI | 1699861377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 19692) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.069458) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-10-05 |