| NPI | 1174684716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 30488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M4768) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-11-13 |