| NPI | 1790711752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: OH 35.064465) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-064465) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-01-05 |