| NPI | 1447696851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.127660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R2381) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2025-10-07 |