| NPI | 1902845597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C55843) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35076862) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-03-26 |