| NPI | 1851543342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.097986) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301093474) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2011-10-26 |