| NPI | 1992700678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 39639) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35078596) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-11-10 |