| NPI | 1447547385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.132469) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01072923A) |
| 207P00000X Emergency Medicine (Licence: KY 51681) | |
| 207Q00000X Family Medicine (Licence: IN 01072923A) | |
| 207Q00000X Family Medicine (Licence: OH 35.132469) | |
| 207Q00000X Family Medicine (Licence: KY 51681) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2020-09-09 |