| NPI | 1275575292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.075884) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.075884) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 3507584) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2017-09-26 |