| NPI | 1992762736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34004773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02005330A) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2025-06-11 |