| NPI | 1134156250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35082721V) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35082721) |
| 207P00000X Emergency Medicine (Licence: IN 01079908A) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2024-04-11 |