| NPI | 1265963680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7673367-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME144233) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-10-19 |