| NPI | 1215965579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P6556) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 34123) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2024-08-14 |