| NPI | 1730415332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.003366) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2022-04-08 |