| NPI | 1811914450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2000157005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-076162K) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-02-07 |