| NPI | 1700813490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-087639) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35087639) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2022-07-01 |