| NPI | 1821220146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.120394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2011-01974) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2013-05-16 |