| NPI | 1336350644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD17866) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57009140) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2013-02-12 |