| NPI | 1477595569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.005747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 2039) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-06-20 |