| NPI | 1134532435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 74098) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R5360) |
| 207P00000X Emergency Medicine (Licence: MI 5101021182) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2023-10-06 |