| NPI | 1841243680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34-008909) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 013218) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2010-01-21 |