| NPI | 1891741005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 44172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35081619) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2015-08-21 |