| NPI | 1750796207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35127357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2017-00625) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2018-06-29 |