| NPI | 1073044384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V3868) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.138405) |
| 207P00000X Emergency Medicine (Licence: NH 21319) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX V3868) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-12-26 |