| NPI | 1891933156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.121435) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A120224) |
| Enumeration Date | 2009-01-25 |
| Last Update Date | 2018-03-15 |