| NPI | 1518962281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-055611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35055611) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2014-05-22 |