| NPI | 1316272149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.010273) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.003258) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2013-03-21 |