| NPI | 1982801593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 51453) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 000000000000) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2017-10-18 |