| NPI | 1760794804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.098568) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.020279) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2012-03-09 |