| NPI | 1639146863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01070922A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35057470) |
| 207Q00000X Family Medicine (Licence: OH 35057470) | |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2017-02-03 |