| NPI | 1144808700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U9355) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351048036) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2024-06-18 |