| NPI | 1285827634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 094780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME114734) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2013-09-24 |