| NPI | 1437443082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 47307) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R2625) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2023-05-01 |