| NPI | 1134549546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T9771) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0011999) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2022-09-11 |