| NPI | 1831766492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 215990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.251345) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2024-11-15 |