| NPI | 1346580693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020330) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2024-09-17 |