| NPI | 1255787776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R5534) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID O-1530) |
| 207P00000X Emergency Medicine (Licence: OR DO207527) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2021-11-30 |