| NPI | 1174249353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP10084749) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4352001076) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2023-06-26 |