| NPI | 1801810916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 29241) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.091732) |
| 207P00000X Emergency Medicine (Licence: IN 01053943A) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-07-22 |