| NPI | 1881647956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX J4594) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35C.001377) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-04-02 |