| NPI | 1740212471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.088919) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 223542) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-01-07 |