| NPI | 1831465632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.014405) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NC 2013-02231) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2020-06-26 |