| NPI | 1558523753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 073136) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.098260) |
| Enumeration Date | 2008-06-28 |
| Last Update Date | 2015-01-22 |