| NPI | 1811928302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 67202) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 192994) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2010-04-08 |