| NPI | 1194258954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD213509) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 11410741-1205) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2023-02-06 |