| NPI | 1770718421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 14485) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.096200) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2014-01-17 |