| NPI | 1427167543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 26906) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 02385) |
| 207P00000X Emergency Medicine (Licence: WV 812) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 34-003420) | |
| 207P00000X Emergency Medicine (Licence: OH 34-003420) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-10-04 |