| NPI | 1720293517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-33762) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34-009174) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2015-04-28 |