| NPI | 1215137666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 02004040A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.009055) |
| 207P00000X Emergency Medicine (Licence: KY 03624) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2013-10-29 |