| NPI | 1245385079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9184) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35088841) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-11-09 |