| NPI | 1689685505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35-061243) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35061243) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2009-12-10 |