| NPI | 1114930906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S1918) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A54609) |
| 207P00000X Emergency Medicine (Licence: HI 16430) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2019-07-12 |