| NPI | 1548350325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35070923) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: OH 35070923) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: OH 35070923) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |