| NPI | 1497721633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME108060) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35049284) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2012-10-26 |