| NPI | 1699903849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC MMD.34540 MD) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.097830) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2012-07-13 |