| NPI | 1154653178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 9449A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N1563) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2022-08-22 |