| NPI | 1780796730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 22993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-073369) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-10-18 |