| NPI | 1073757407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX H3664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 57857) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2024-04-05 |