| NPI | 1043452311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-02550) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.099487) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2015-04-17 |