| NPI | 1386811669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.133742) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 2395) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2018-07-09 |