| NPI | 1821185836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.147136) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-12237) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-06-13 |