| NPI | 1396787289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A160975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.129788) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-10-25 |