| NPI | 1851671275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 62562-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.019529) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2024-01-17 |