| NPI | 1194043653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.121469) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R2427) |
| Enumeration Date | 2010-05-08 |
| Last Update Date | 2019-07-16 |