| NPI | 1205063286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1699) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34009984) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2013-06-05 |