| NPI | 1982668430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A9117) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34008138) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-08-26 |