| NPI | 1619918174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35037365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 25482) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-10-19 |