| NPI | 1972597664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.004073) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 34004073R) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2023-09-11 |