| NPI | 1720254105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.120552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 258915) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2022-05-18 |