| NPI | 1447666979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R5209) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 3027) |
| 207P00000X Emergency Medicine (Licence: OH 58.005637) | |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2022-09-21 |