| NPI | 1922214741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34-008971) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 05008) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2022-10-13 |