| NPI | 1275844979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 47628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.098775) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2013-08-12 |