| NPI | 1083008676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R8953) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D89810) |
| 207P00000X Emergency Medicine (Licence: VA 0101270998) | |
| 207P00000X Emergency Medicine (Licence: NM MD2019-0208) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-09-26 |