| NPI | 1669684379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-00394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.091255) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-07-02 |