| NPI | 1205363488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T2744) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 68114) |
| 207P00000X Emergency Medicine (Licence: NY 303840) | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2023-11-16 |