| NPI | 1184737157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 010074) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL DO 770) |
| 207Q00000X Family Medicine (Licence: AL DO 770) | |
| 207Q00000X Family Medicine (Licence: OH 010074) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-05-29 |