| NPI | 1912975194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA O5009254C) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34007573) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-12-11 |