| NPI | 1720142391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 1942) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.008542) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2016-11-01 |