| NPI | 1073817359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2831) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58003740) |
| Enumeration Date | 2010-12-31 |
| Last Update Date | 2021-04-13 |