| NPI | 1194990754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 4270) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.010035) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2013-10-25 |