| NPI | 1730135476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.047667) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 26999) |
| 207P00000X Emergency Medicine (Licence: IN 01052357A) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2008-05-05 |