| NPI | 1013177328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 11641159-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 148918) |
| 207P00000X Emergency Medicine (Licence: CO 0049751) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2020-04-10 |