| NPI | 1093276685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V1164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2022016879) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2024-07-08 |