| NPI | 1053934760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V0344) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014189) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2024-06-26 |