| NPI | 1073589255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61319327) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q5400) |
| 207P00000X Emergency Medicine (Licence: MA 217292) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2022-08-12 |