| NPI | 1285987248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 212599) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58004617) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2016-09-14 |