| NPI | 1568410215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35075182W) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: OH 35075182) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-08-14 |