| NPI | 1194280743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.168948) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.140301) |
| 207P00000X Emergency Medicine (Licence: TX U3344) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX U3344) | |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2024-10-28 |