| NPI | 1720436751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.007550) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2023-11-01 |