| NPI | 1225058985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-081159) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2019-09-16 |