| NPI | 1740475516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34009123) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N5263) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2026-06-16 |