| NPI | 1700553294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 50.007110RX) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO PA.0008267) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2024-02-14 |