| NPI | 1700864824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.123087) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: OH 35.123087) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2023-07-25 |