| NPI | 1891054953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.018513) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR DO176924) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2026-05-20 |