| NPI | 1083057483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 283682) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301103569) |
| 207P00000X Emergency Medicine (Licence: TX S0136) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2020-12-16 |