| NPI | 1770584526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-046513) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OH 35046513) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2009-03-08 |