| NPI | 1114318318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 1546) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX S5609) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2020-10-21 |