| NPI | 1174698344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M8156) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102203920) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2022-10-25 |