| NPI | 1932144821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-05-5386) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 15339) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2015-02-09 |