| NPI | 1427143700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME100116) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35088643) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-06-11 |