| NPI | 1003087248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 05380) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.010238) |
| Enumeration Date | 2008-03-16 |
| Last Update Date | 2023-10-18 |