| NPI | 1952717373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.012449) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R7756) |
| 207P00000X Emergency Medicine (Licence: IL 036168213) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2025-10-22 |