| NPI | 1992110555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 079383) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.127086) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2021-09-27 |