| NPI | 1225246903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9227) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 55789) |
| 207P00000X Emergency Medicine (Licence: MI 4301086081) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2023-04-20 |