| NPI | 1750322970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 38264) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.131704) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-02-09 |