| NPI | 1003077058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N9739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN12711) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-05-12 |