| NPI | 1558331520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-08-0654-0) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-08-0654) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2015-03-06 |