| NPI | 1730540766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 008442) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.007631) |
| 207P00000X Emergency Medicine (Licence: OH BO9667710-616-09) | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2021-10-27 |