| NPI | 1497798151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.007602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 053666) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2009-08-10 |