| NPI | 1790783694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34-007059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34007059) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2023-03-24 |