| NPI | 1578783536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 124148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 260155) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2015-04-10 |