| NPI | 1679624043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13823854-1205) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35.089152) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: OH P0948731) | |
| 207P00000X Emergency Medicine (Licence: WV 27856) | |
| 207P00000X Emergency Medicine (Licence: OH 35.089152) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX R4766) | |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2024-04-11 |