| NPI | 1184623209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 07824) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS011029L) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2013-07-03 |