| NPI | 1700832946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 2897) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34005489R) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-01-07 |