| NPI | 1780662403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G87130) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.054529) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2009-01-15 |