| NPI | 1841828605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1022245) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.148052) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-05-27 |