| NPI | 1205041308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3046) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301088309) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-12-30 |