| NPI | 1669424149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA MD00040867) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35C.002978) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-09-29 |