| NPI | 1912446972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.013669) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 011319) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2024-10-22 |