| NPI | 1174757553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-097574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A119065) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2011-11-17 |