| NPI | 1417188491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.129017) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01070876A) |
| 207P00000X Emergency Medicine (Licence: PA MD446903) | |
| 208600000X Surgery (Licence: PA MD446903) | |
| 208600000X Surgery (Licence: OH 35.129017) | |
| 208D00000X General Practice (Licence: IN 01070876A) | |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2024-10-18 |