| NPI | 1801357850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023010990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.015104) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2024-02-02 |