| NPI | 1487940060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS12456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34010661) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2014-12-31 |