| NPI | 1043431406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2256) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 5850) |
| 207R00000X Internal Medicine (Licence: KY 02932) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-09-15 |