| NPI | 1053842831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T5944) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 67041) |
| 207P00000X Emergency Medicine (Licence: KY R4465) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2024-04-09 |