| NPI | 1801960349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.084767) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD13291) |
| 208600000X Surgery (Licence: OH 35.084767) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-06-02 |