| NPI | 1306199898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 10318034-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A123316) |
| 207P00000X Emergency Medicine (Licence: PA MD454187) | |
| Enumeration Date | 2012-10-20 |
| Last Update Date | 2022-07-21 |