| NPI | 1851832109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S4138) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.138127) |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2020-11-13 |