| NPI | 1174984058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 17163) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R4911) |
| 207P00000X Emergency Medicine (Licence: HI DOS-1915) | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2019-08-15 |