| NPI | 1851702054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.132155) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC MD51445) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2022-07-21 |