| NPI | 1285650978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2010-01730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.087179) |
| 207P00000X Emergency Medicine (Licence: KY 42033) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-04-01 |