| NPI | 1750572491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A11481) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.009538) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2011-08-31 |