| NPI | 1417908385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35085676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 26113) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-04-14 |