| NPI | 1083097786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R5823) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT208855) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2022-08-30 |