| NPI | 1144616889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01081470A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.129467) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2020-11-12 |