| NPI | 1427474964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.012079) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 05-50386) |
| 207P00000X Emergency Medicine (Licence: MO 2023021752) | |
| 207P00000X Emergency Medicine (Licence: KY C2487) | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2025-07-03 |