| NPI | 1104877828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02004003A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34008624) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2017-02-07 |