| NPI | 1700462637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 011639) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.016855) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2025-04-19 |