| NPI | 1689881625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2011-00079) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OH 35.091483) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2016-01-27 |