| NPI | 1275980237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S7407) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT210795) |
| 207P00000X Emergency Medicine (Licence: AR E-12174) | |
| 207P00000X Emergency Medicine (Licence: OK 37033) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2021-03-23 |