| NPI | 1750963633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.150224) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 35284) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-08-30 |