| NPI | 1174574297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 34876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35081891H) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2012-08-27 |