| NPI | 1497916498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A10310) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34000179) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |