NPI | 1962609164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34010016) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 262845) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2011-09-30 |