| NPI | 1710365788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35.137626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY TL-50324) |
| 207P00000X Emergency Medicine (Licence: OH 35.137626) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-07-26 |