| NPI | 1841481314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35094014) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01079758A) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2019-06-11 |