| NPI | 1972733574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH FK3796995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094775) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2013-08-13 |