| NPI | 1205198827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35126399) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT202149) |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2015-06-05 |