| NPI | 1053792895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 73154-21) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WI 73154-21) |
| 207P00000X Emergency Medicine (Licence: MI 5101021818) | |
| 207P00000X Emergency Medicine (Licence: TX S0411) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX S0411) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2023-05-23 |