| NPI | 1275950560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.134887) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY TP946) |
| 207P00000X Emergency Medicine (Licence: KY R3429) | |
| 207P00000X Emergency Medicine (Licence: KY 50178) | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2018-09-18 |